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Sample Record for 2014-01-30-12002045

Note: Fields with no data or with a value of "Unknown" will not be displayed on the print out.

Project Information

Project ID: 9999 DEA: 00000000 EFIS: 0000000000 COOP: 99999333399 MINOR: 333333 Permit Numbers: 555555 0400NRT0000 QA Service Level: 1
DIST-CO-RTE-PM: 03-SAC,OMG-888,99,80-0.6-0.6
Work Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Location Description: THIS PROJECT RECORD WAS ADDED FOR DIME DEVELOPERS - DATA SUBMITTED FOR THIS PROJECT SHOULD NOT BE USED FOR ANY OTHER PURPOSES.
Contractor Name: YYZ
Contractor Address: 1234 address, Sacramento, CA 95824
Resident Engineer: RE_first RE_last Structure Rep.: SR_Last, SR_First

Sample Information

DIME Sample ID: 2014-01-30-12002045
TL Number from the TL Form:
Sample Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Sample Organization Contact: 7146885366
Type of Sample: Quality Control
Type of Material: Aggregate
Sample Taken Date: 01/30/2014
Date that the sample was received by the laboratory/organization performing the testing: 01/29/2014
The quantity of what the sample constitutes: 3 bags
A brief description of the sample: Sample is
From where was the sample collected: Source
Laboratory sample identification: SID1234
Structure unique identifier:
Structure name:
The fabricator/manufacturer/facility name: Source Name

Material Information

Source Identification (SMARA or name of Pit): Smara 1234
The fabricator's/manufacturer's product name for the sample: Prod Name
The fabricator/manufacturer designation for the sample: Desig
The plant number: Plant1234
A detailed description of where the material sample was collected: From sheelbarrow
Where the material sample would have been placed if not sampled: o
Primary Aggregate Nominal Size: 1 inch
The concrete mix design number: Mix1234
Lot number:
Sublot number:

Test Results

Test 1 of 6

DIME Test ID: 2014-01-30-12002045-1
Test Method: ASTM C117-04: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Test 2 of 6

DIME Test ID: 2014-01-30-12002045-2
Test Method: ASTM C136-06: Standard Test Method for Sieve Analysis of Fine and Coarse Aggregates
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Test 3 of 6

DIME Test ID: 2014-01-30-12002045-3
Test Method: ASTM C566-04: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Test 4 of 6

DIME Test ID: 2014-01-30-12002045-4
Test Method: ASTM D2419-09: Standard Test Method for Sand Equivalent Value of Soils and Fine Aggregate
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Test 5 of 6

DIME Test ID: 2014-01-30-12002045-5
Test Method: ASTM C117-13: Standard Test Method for Materials Finer than 75-μm (No. 200) Sieve in Mineral Aggregates by Washing
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Test 6 of 6

DIME Test ID: 2014-01-30-12002045-6
Test Method: ASTM C566-13: Standard Test Method for Total Evaporable Moisture Content of Aggregate by Drying
Submitted By Organization: CT HQ - Sacramento Office of Structural Materials Field Laboratory
Organization Address: 5900 Folsom Blvd,
Organization City: Sacramento
Organization State: CA
Organization Zipcode: 95819
Organization Email: bscott@altavistasolutions.com
Organization Phone: 7146885366
Data has not been verified.

Tests Assigned to this Sample

DIME Test IDTest MethodAssigned DateTest DateAssigned ByAssigned LabTest CommentsAssigned To
No tests have been assigned to this sample.